Surgical Treatment of Sacrococcygeal Pilonidal Sinus using Wide Excision and Coverage with Fasciocutaneous Advancement Flap.

Lee, Jin Seok; Song, Hoon; Hong, In Pyo

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(2):169-173.
Published online March 1, 2008.

Surgical Treatment of Sacrococcygeal Pilonidal Sinus using Wide Excision and Coverage with Fasciocutaneous Advancement Flap.

Jin Seok Lee, Hoon Song, In Pyo Hong

Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea. nmcps@unitel.co.kr

Abstract

PURPOSE
Sacrococcygeal pilonidal sinus is a chronic inflammatory disease that mostly affects young people, which warrants surgical intervention. Although many surgical methods have been suggested, an optimal surgical method remains controversial because of high recurrence rates and postoperative complications. The objective of this study is to evaluate the results of wide excision and coverage with fasciocutaneous advancement flap for the treatment of sacrococcygeal pilonidal sinus, and to assess the usefulness of this method METHODS: From May 1995 to October 2006, the authors treated 19 patients with the use of coverage with fasciocutaneous flap after wide excision. The results were evaluated regarding recurrence rates, complications, and the change in sensitivity of the gluteal region after surgery. The follow-up period was 7 to 142 months (mean, 76 months). All patients were male.
RESULTS
Postoperative complications were wound infection at the suction drain insertion site and skin necrosis around the suture margin in one case, respectively. During the follow up period, only one recurrence (5.3%) was seen in fifth postoperative month, which was successfully treated by the same operative procedure. There was no other complications such as seroma, hematoma, wound dehiscence and flap loss. Extensive scarring and anatomic distortion did not occur in the reconstructed area. In addition, sensitivity of the gluteal region did not diminish. The aesthetic results were satisfactory for all patients as well.
CONCLUSION
The authors advocate that fasciocutaneous flap closure be a good alternative method to cover defects after the excision of sacrococcygeal pilonidal sinus.

Keywords: Pilonidal sinus; Fasciocutaneous flap

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